β2微球蛋白与C反应蛋白对Ⅳ型心肾综合征诊断及预后判断意义.docVIP

β2微球蛋白与C反应蛋白对Ⅳ型心肾综合征诊断及预后判断意义 　　摘 要 目的：探讨β2-微球蛋白（β2-MG）与C反应蛋白（CRP）对Ⅳ型心肾综合征（CRS）的诊断及预后判断价值。方法：随机选取中老年Ⅳ型CRS确诊患者（A组）、慢性肾脏病（CKD）患者（B组）及健康体检者（C组）各30例；入院后查肾功能、β2-MG及CRP等，并对A组患者随访1年，据预后分为死亡组（D组）和生存组（E组）。结果：A组CRP及β2-MG水平显著高于B组和C组，LVEF显著低于B组和C组（P0.05）；D组CRP及β2-MG水平显著高于E组，LVEF显著低于E组（P0.05）。CPR和β2-MG的ROC曲线下面积分别为0.698和0.697，敏感性96.7%和80.0%，特异性43.4%和66.7%。结论：β2-MG与CRP均是判断Ⅳ型CRS的较好生化指标。二者与LVEF联合判断有助于提高诊断准确性，并能更好地判断预后。 　　关键词 β2-微球蛋白 C-反应蛋白 慢性肾脏病 Ⅳ型心肾综合征 　　中图分类号：R541.61 文献标志码：B 文章编号：1006-1533（2018）07-0049-04 　　Significance of the detection of β2-microglobulin and C-reactive protein in the diagnosis and prognosis of type Ⅳ cardiorenal syndrome 　　TANG Te* 　　（Shaoyang No.1 Hospital， Hu’nan 422000， China） 　　ABSTRACT Objective： To investigate the significance of the detection of C-reactive protein （CRP） and β2-microglobulin 　　（β2-MG） in middle-aged patients with type Ⅳ cardiorenal syndrome （CRS）. Methods： The randomly selected elderly patients with type Ⅳ CRS were divided as a group A， patients with chronic kidney disease （CKD） as a group B and healthy physical examination subjects as a group C with 30 cases each. Their renal function， β2- MG and CRP levels were detected. The patients in group A were followed up for a year and then divided into a death group （group D） and a survival group （group E） based on their prognosis. Results： The levels of CRP and β2-MG were remarkable higher and LVEF was remarkable lower in group A than in group B and C （P0.05）. The levels of CRP and β2-MG were remarkable higher and LVEF was remarkable lower in group D than in group E （P0.05）. ROC curve areas diagnosed by CPR and β2-MG were 0.698 and 0.697， sensitivity 96.7% and 80.0%， and specificity 43.4% and 66.7%， respectively. Conclusion： β2-MG and CRP are good biochemical markers for the determination of type Ⅳ CRS. They can be helpful to improve the diagnostic accuracy of type Ⅳ CRS and to better determine the prognosis of patients when combined with LVEF. 　　KEy WORDS β2-MG； CRP； chronic kidney di